Reflections on a Year with Cancer

You know those stories that people tell where somebody is described as “going weak in the knees,” or when there’s news that people have to “take sitting down?” Those had always seemed like exaggerated figures of speech to me. I mean, who really goes all noodle-legged in the face of bad news, after all? Certainly not I. 

I have never needed one of those Victorian fainting couches to catch my swooning form. I have no smelling salts in my medicine cabinet. And if you see tears welling up in my eyes, you can pretty rightly assume it’s from hay fever.  

My seemingly stoical DNA, you see, derives from a rather chilly blend of tight-lipped Englishmen, hard-headed Germans, windblown Scots, and the kind of  rugged, sunshine-is-for-sissies northern Europeans who chiseled out a living from the frozen fjords. Stout hearts and dry eyes—that’s us. As one author put it, “If I were commissioned to design the official crest for the descendents of emotionally muzzled Vikings everywhere, I would begin by looking up the Latin phrase for ‘No thanks, I’m fine.’” Exactly.

But on the evening of August 20, 2012, when my husband carried home the heavy news that our ten-year-old son, Jonah, had been diagnosed with leukemia, I crumpled onto the bottom step of our family’s stairway and sobbed.
 
All through that evening and for many of the days that followed I learned what it was to go weak in the knees in the most literal sense—no metaphor about it. Each time a doctor would bring new information, I had to take it sitting down. Every time the phone demanded to be answered, my chest felt squeezed in a vice that gripped tighter with every ring.
 
My child may die. My precious firstborn son may be taken from us. Everywhere I went, I seemed to feel an unbearable weight pressing down on my shoulders—a weight that I could not carry. We were given hefty stacks of informational books and brochures, but I could not open them. I could not allow my eyes to rest on phrases like “mortality rate” and “likelihood of relapse.” These were words too heavy for me to lift from the page.
 
My child may die. It continues to be a weight that I cannot carry. But I have learned that it is also a weight that I need not carry. That I do not carry. That is not mine to carry at all.

Words Made Alive

Two years ago, our church started a Sunday School class to teach the Heidelberg Catechism to the children. Week after week my kids would recite from memory the answer to that week’s question and would review the answers to the questions that preceded it. This means that week after week, the question would come back: “What is your only comfort in life and in death?”

Then a chorus of sing-song treble voices would reply:

“That I am not my own, but belong— body and soul, in life and in death—to my faithful Savior, Jesus Christ. He has fully paid for all my sins with his precious blood, and has set me free from the tyranny of the devil. He also watches over me in such a way that not a hair can fall from my head without the will of my Father in heaven; in fact, all things must work together for my salvation. Because I belong to him, Christ, by his Holy Spirit, assures me of eternal life and makes me wholeheartedly willing and ready from now on to live for him.”

In the frightening days that followed Jonah’s diagnosis, those familiar lines that had rattled around in my own head for so many years and that had echoed around the walls of the Sunday school classroom for so many weeks sputtered to life. That dusty paragraph began lighting up like the county fair at nightfall. I had seen those antique words before and believed them, but never quite so fully. Never quite so desperately. Never in such bright, neon colors.

Each night as I pleaded with God for Jonah, I pulled those words, like a lifeline, into my prayers: “Jonah is not his own. He is not my own. God Almighty, he is your child. And nothing can happen to a hair on his head or to a blood cell in his body apart from Your will.” And even in the praying of those words, that suffocating, crippling weight began to lift. Jonah belongs to his faithful savior. Body and soul. In life. And, yes, even in death.

Psalms, too, and hymns that I had sung for years and committed to memory—sometimes without much thought—were now surfacing in my head and heart and proving to be both priceless and indispensable. All those pictures of God as a refuge, as a fortress, as a rock, as a tower, as a physician, as a lover, as a friend now meant something far more concrete. Here was comfort beyond imagining. Here was peace beyond understanding.

It was as if I, when I was feeling particularly wealthy, had stuffed a large roll of high-denomination dollar bills into my pockets without thinking and then forgot about them. But then, when hard times fell and I thought I was going broke, I put a hand into my pocket and discovered that I was still rich after all—and that I not only had all that I needed, but that what I did have had appreciated in value.

Here were these words, that had seemed at times—especially when I was young and tired of memorizing—to be so much gravel, tossed into my empty little head and tumbled around over the years. But now, here they were again, pouring back out all shining and precious and polished smooth—not gravel at all but rubies.

“God is our refuge and strength, a very present help in trouble. Therefore will not we fear, though the earth be removed, and though the mountains fall into the heart of the sea” (Psalm 46:1-2). I remembered those lines as a little ditty set to a tune for teenage voices and a solo guitar. But thanks to that melody, simple as it was, those words were epoxy-glued into the back pages of my mind such that I never lost them. But I had also never really deeply considered them.

It’s not that I had ever doubted the truth of those words, but I believed them, more or less, in the abstract. They existed somewhere in the clouds. Now, however, in the middle of my trouble, with my comfortable little world falling into the sea, those true words came down out of the ether and touched the very solid ground beneath my feet. God is a refuge—from fear and death. He is strength—when my knees buckle and I cannot stand. He is a very present help—a right-here-right-now help; a help mediated through comforting words and free babysitting and hot meals and carpool rides and peaceful sleep. He is a help in trouble—in cancer and confusion and grief. Therefore we will not fear. We will not be afraid of this. Not even if the world crumbles around us and cancer does its worst.

Mongering Fear

The more I’ve read about cancer, the more it seems that health publications (both mainstream and alternative) want everyone to be very afraid of cancer. Scroll through a hundred health blogs, and flip through a teetering stack of health magazines, and it seems that this is the endlessly repeated headline: “5 Foods that Fight Cancer.” “12 Secret Weapons Against Cancer.” “17 Strategies for Staying Cancer-Free.” Without the fear of cancer, I imagine that readership would plummet.

Believe me, I fully understand the desire to learn more about what causes cancer and what cures it. I had a cancer scare of my own not long ago, and I (like most people I know) have had friends and relatives who have died of various forms of cancer. It's a disease that touches the lives of just about everybody, so it's no surprise that we fear it. But it's also no surprise that there are people out there who are eager to prey on people's fears. 

I once read a post, shared by a well-meaning Facebook friend, that said, "Finally! Johns Hopkins Medical School reveals the truth about cancer!" The link offered a numbered list of generic tips (Stop eating sugar!) but also endorsed a number of health products—by brand name—that we should buy. This seemed more than a little fishy, so I checked the sources. It turned out to be a hoax; Johns Hopkins had shared no such thing and had devoted a whole page of its web site to dispelling the misinformation and outright lies. But by that time, the link had already been shared on Facebook upwards of 20,000 times.

The reason I think we are so eager to read all those cancer articles and to believe sketchy posts like the one I mentioned is that it can make us feel like we have the tools to get back in control of our lives. Cancer is scarier than most diseases because it is still, in spite of all that up-to-date information (and misinformation), shrouded in mystery. 

Why does one of our children get leukemia while the rest remain perfectly healthy? Why did one of my mom's siblings get cancer while none of the other 8 have? How is possible that a man who smoked his entire life never gets lung cancer, while a woman who never even touched a cigarette dies of the disease? The answer, from what I can tell, is: We don't know. Cancer is a bogy that seems to lurk around every corner, and we feel helpless against it.

A sense of helplessness, however, can give us a glimpse of something like Truth. And that kind of Truth can be terrifying. Our days are numbered, and not—contrary to to our hopes and wishes—by us. So it’s easy, even for Christians like us who should know better, to want to panic in the face of our helplessness and to grasp at some semblance of control. We could easily spend countless hours trying to keep up with the latest health advice—even when we know that latest health advice keeps changing on us again and again and again.

First we're told to hide from the sun to avoid cancer. And then we find out that our sun boycott is causing Vitamin D deficiency, which can cause cancer. So we start chugging fish oil for the Vitamin D. But then we are told that the fish oil can be tainted with mercury, which is linked to cancer. We work hard to provide our families with good nutrition that will fight cancer. But then it turns out that kids who have better nutrition are also more likely to be tall, which puts them at greater risk for cancer. And then when we finally do get cancer, we fight it with radiation and toxic drugs that can cause cancer. Cancer, like Shakespeare’s fool Touchstone, chases us around the world-stage, shouting, “I will kill thee a hundred and fifty ways!” 

I don't think it’s simply a fool's errand to try to steer clear of this threat to our health. Especially not after all that we've been through with Jonah. But at the same time, I think we have to be careful. There does come a point when concern for health becomes obsession with health—when prudence crosses the line into panic and we lose sight of God's promises and providence. 

Whence Comes My Help?

Sitting by Jonah’s sickbed for countless hours has provided me with plenty of time to meditate on our own helplessness—on our own lack of control over so many of the details of our lives. And what’s odd is that our helplessness, while it might seem frightening to some, has actually provided a very real sense comfort because we know that “our help comes from the Lord who made heaven and earth.” 

Who is more helpless than a small child? And yet who in the world is more carefree? That is because a young child is not burdened with a sense of self-sufficiency or a compulsion to pull himself up by his own bootie straps. He is free to rest and play because he knows that somebody else takes care of his needs.

If our lives are ultimately in our own hands, however, then we can never rest, never turn our backs, never loosen our white-knuckle grip for a moment. But if our lives are ultimately in God’s hands, then we are free, like that child, to keep our own hands open—both to give and to receive a thousand other joys. 

As we have dealt with Jonah’s cancer, our helplessness has deepened our dependence on God. And dependence on God, paradoxically, has brought independence—a sweet freedom from all the other cares and worries that can so easily take over.

Even as a Christian, it’s easy to be swayed by the messages of every health article under the sun. But as I’ve read the Bible this year, I’ve noticed that there are an astonishing number of promises from God (you know—the One who made our bodies in the first place?) that have to do with health and strength and long life. And yet I haven’t come across a single one of those promises that hinges on nutrition or exercise or any of the usual concerns. 

I still believe that those concerns are means that God routinely uses to sustain our lives. But if I were trying to compile a list of “Biblical Tips for Better Health,” I think it would have a whole lot less to do with consuming organic produce and joining the gym, and a whole lot more to do with fearing God, honoring parents, befriending Lady Wisdom, and seeking first the Kingdom of God and His righteousness.

Not a hair can fall from our heads—or a cancer cell form in our bodies—without the will of our Father in heaven. He knows what we need before we ask, which means I don't have to keep tying myself into awkward knots in attempt to keep up with all the latest cancer-dodging advice. Resting in God's care allows me to take a step back from the fears of the moment and to gain some perspective on this salutary game of Twister—and to laugh a little. And a merry heart, after all, "doeth good like a medicine."  

Ultimately, our lives are not in our hands. And that truth, instead of scaring us, should allow us to  loosen our kung-fu death grip on health, to step away from all those hot-off-the-presses articles about the latest cancer scare, and to quit worrying. Seriously. Quit. Worrying is bad for our health. And which of us by worrying can add a single day to his life? Rather, “Fear the Lord and depart from evil. It will be health to your flesh and marrow to your bones” (Proverbs 3:7b-8). 

That right there is a ruby to keep in your pocket.

The Belly of the Whale

Just last week my husband took all the kids to a local nursing home to bring a little joy to the lonely and afflicted. And the next day Asaph, who is five years old, said to me, “Mom? You know that place where people go to live until they die? I saw an old lady there who was sitting in a wheelchair. And her teeth were out, so she pushed them back into her mouth. I said hi to her, but she didn’t hear me.”

It’s shocking, isn’t it, son? It’s shocking that we crumble until our legs cannot hold us. Until our teeth fall out of our mouths. Until our ears grow numb to the voices of children yelling “Hi!” six inches from our heads. But what’s more shocking is that we forget this about ourselves. Here in this university town of ours, where the beautiful and the invincible spill out of every coffee shop and swarm the halls of the shopping malls, we find that the fresh supply of youth never dries up. We spend our days in the house of feasting, toasting each other’s health, and checking each other’s sexy curves. Meanwhile, life’s epilogue is lived out behind closed doors, along sterile hallways under fluorescent lights, so that the rest of us can forget the final pages of our story.

But not my children. My own Jonah has slept within the black innards of the whale. He has looked death straight in the mouth and smelled its foul breath. My own little blue-eyed five-year-old has navigated through those urine-scented hallways in the house of mourning and learned some wisdom. He has seen our latter end. 

The truth is that we are all in that place where we will live until we die. But while I will try to push that final day back as long as I can, I never want to spend so much time simply staying alive that I forget to live. As one author friend put it, “Life is meant to be spent.” And not just, I might add, on ourselves. 

Long life can be a great blessing, but what good is a long shelf life if our contents are never used up before we reach our expiration date? Better to be a cheap plastic jug of grape juice cocktail—or a boring old cup of cold water, for that matter—that is poured out to quench someone's thirst, than to be a bottle of the finest Châteauneuf-du-Pape that is kept safely corked on a shelf for decades until its contents turn to vinegar. 

My grandfather (who died of cancer) did not live as long as many of his peers, but he also lived more within those years than many of his peers. He learned to speak English, served in a war, raised nine children, was faithful to his wife, ran a dairy farm, felled trees (as well as a few of his fingers), worked in the church, owned a retirement home, excelled at bowling, and poured love on his dozens of grandchildren. 

When I was about Asaph’s age, my grandfather used to do a trick in which he brushed his teeth and whistled at the same time. I thought it was hilarious—him holding his dentures and toothbrush in his mangled fingers, while a merry tune played on his wrinkled lips. 

When my own teeth fall out, I hope it will make my little grandchildren laugh. And I hope to be laughing with them. 

Manna in the Wilderness

In the early days of Jonah's treatment, I parked in the Children's hospital garage next to an SUV that had the words "CHILDHOOD CANCER SUCKS!" scrawled in gold paint across the back windows. And I don't disagree. 

I have watched my son vomiting for hours, writhing in pain while his hair falls out and his wide eyes plead for a relief that is far from coming. But for the record, you need to know that cancer is not the worst thing that can happen to you. In fact, we have gained so much from this experience already that we may one day look back and see that cancer was the actually one of the best things that ever happened to us. And even in the hardest stages of his treatment, Jonah has discovered that a life-threatening illness is not without its perks.

Just last weekend, Jonah was invited to throw the first pitch at a Spokane Indians baseball game, escorted onto the field by Super Bowl MVP Mark Rypien. Jonah has been in the dugout and on the field to shake hands with Seattle Mariners. He’s had a movie star come to visit him. He has heaps of books and toys and crafts and cards and even an iPad thanks to the kindness of those who heard of his plight. And now, through the Make-A-Wish foundation, he’s in the process of planning a dream vacation to Hawaii—something we could never afford to do with him otherwise. So much love, joy, peace, and just plain fun have come his way on account of his cancer that one of our other boys once said, “Aw, man! I wish I had cancer.” 

The Children’s Hospital has also done such a great job of creating a welcoming environment for these sick kids that all our boys clamor for the chance to go along with Jonah for his appointments. Jonah himself sometimes laments that his days of staying overnight at the hospital are over. He loves all the nurses and the one-on-one attention from parents and grandparents. His memories of cancer have been so well seasoned with blessings that he has more than once told us he wishes he could start his treatment all over again. And he is no masochist. This was simply the best-worst year of his life. 

Power Made Perfect in Weakness

This has, without question, been the most difficult year of our lives. My son has life-threatening disease. But do I wish this had never happened? Do I wish I could erase the last twelve months and start them fresh and clean and cancer-free? I hesitate. But strange as it sounds, I don't.

I have had people tell me that they just don’t think they could do what we’ve done; that they couldn’t handle facing childhood cancer; that it would simply be too hard. And I suppose the expected reply would be, "Oh, no, of course you could! You're a strong person. You could handle it if you had to." Well, maybe it's that stiff-upper-lip DNA of mine, but I'm not always a good cheerleader. In fact, what I generally say is, “Yeah you’re right. It is too hard. You couldn’t do it.” 

The reason I say that, however, is that I can’t do it either. I can’t handle it. Not me. Not our family carrying all this trouble on our own strength. We didn’t do it. We didn’t handle it—at least not in some kind of stoical, self-sufficient, inner-strength, “No thanks, I’m fine” kind of way. 

Rather, we were helpless. We were weak in the knees. We had to take it sitting down. But God was our strength. We were neck-deep in trouble. But He is a very present help in trouble. We were faced with the fear of death. But our comfort is that we belong, even in death, to our faithful savior, Jesus Christ. This year was God’s work. This year was also—through all that our friends and family and churches did to carry our burden—your work. And having seen with my own eyes the unfailing mercy and goodness of God, I am no longer afraid.

It’s been one year since Jonah's diagnosis—when the battle for his life began—and we have seen our prayers answered again and again. After a summer full of baseball and swimming and bike riding and lacrosse, he started school with his class last week, and he visits the hospital only once a month. His hair, his color, and his laughter are back. But the fight for his life is not over; we are facing the Last Enemy, even now. My child may die. Even after a year, I still can hardly bring myself to say those words aloud, and my throat aches if I try. 

This has been a year of testing, but this has also been a year in which all those abstract truths that we have always believed truly put on flesh. God's power is made perfect in our weakness. God is our refuge and strength. This is why my knees are steady. This is why that terrible weight is gone.

You have dealt well with your servant,
    O Lord, according to your word.
Teach me good judgment and knowledge,
    for I believe in your commandments.
 Before I was afflicted I went astray,
    but now I keep your word.
You are good and do good;
    teach me your statutes. (Ps 119:65-68)

Spinal Tap

It's Tuesday morning when I first sit down to write this post, and the sunshine is blazing through the massive eastern windows of the waiting room in the children's hospital oncology clinic. Brilliant light glares through the ten-foot-high wall of glass with an intensity that seems overzealous for so early in the season. It flashes off of glossy magazine covers and sparkles cheerily through the saline fluid in Jonah's IV bollus. It warms the back of my shoulders to the point of discomfort and renders the feeble, electronic glow of my laptop screen almost useless. 

It's hard to believe that only one week earlier, I was snapping photos of snow falling on my flower garden. This sudden explosion of summery heat has set me—and my spring tulips—into a kind of squinty-eyed shock. Pale, winterized north Idaho inhabitants like me generally require a more gradual change of season. I'm used to waiting through drizzly May days for the occasional break in the clouds when a patch of promising sunlight will rest on the rug just long enough to lend it a hint of lingering warmth. I am used to keeping the winter coats ready on their hooks, just in case, until sometime in July. I am used to sending my kids to their first morning swimming lessons of the summer when the outdoor thermometer still reads 48°. But this? I am not used to this. This is true water park weather, and it's only the first week of May. 

Jonah is sprawled out horizontally across one of the small armless waiting room couches. It's safe to say that he is basking, soaking his skinny limbs in the warm tide of sunshine that washes over him. All he needs is a beach towel and a pair of trunks. And yet, here he is, several floors above the street, on a hill overlooking Spokane, waiting not for a for trip down the waterslide into the pool but for a trip down the hallway into a windowless procedure room lit by fluorescent tubes, for an early-morning spinal tap and a dose of toxic drugs. 

Hardly a summer holiday. 

I glance up from my over-bright screen and make brief eye contact with another mom who is sipping hospital coffee from a white styrofoam cup. The sunlight sets curlicues of steam aglow between her face and mine. I very nearly say hello, but she quickly turns her puffy, sleep-starved eyes away toward the window. I follow her gaze to where the tops of the pine trees are lost in the brightness of the sunrise.

Next to her, a dark-haired boy, about Jonah's age, is also waiting, slouched low in his chair. His eyes are closed, and his crossed arms rest across his belly. They are by far the hairiest arms I have ever seen on a child. I try not to stare, wondering if this kid is getting the same chemo as my son. Jonah's own hair held out against the drugs for a long time—much longer than for most cancer patients—but now he hardly even has hair on his head, let alone on his extremities. Even his eyebrows and eyelashes have thinned.

I turn my attention toward him. His feet are propped on a lime-green ottoman, and he is reading—or pretending to read—his paperback. "You want anything?" I ask. Then I remember. "Oh, nevermind. I forgot you can't have anything until after your LP." 

He looks at me from over the top of his book and slowly shakes his head. "Nope." He punctuates the word with a soft pop of his lips on the 'P'. The other mom glances back toward me for just an instant, and then again back to the window, half-closing her eyes against the brightness.

I wonder about trying to meet these people, about asking this other boy his story, maybe make a new hospital friend for Jonah. But asking those sooo-what-brings-you-here conversation starters can be painful and distressing when they are asked in a children's oncology ward. ("Oh, brain radiation. And you?") Sometimes small talk seems, well, too small in the shadow of the enormous, cancerous elephant in the room. So I decide to keep quiet and return to my typing. Besides, I think to myself, it's early, and we are all so sleepy and ridiculously warm in here anyway. 

• • • • • •

The day before, Jonah and I had driven to Riverfront Park to eat a late lunch following a checkup, and we came unprepared for the weather. The afternoon heat slowly baked into Jonah's black jeans and long-sleeved T-shirt, while the May sunlight threatened to burn his bald head. My dark hair absorbed the heat like a cast iron skillet. We moved to some semi-shade and ate our sandwiches on a dusty, metal-grid picnic table. Nearby, a half-dozen flip-flopped moms with squealing children splashed—some of them fully dressed—in the park fountain. No men among them, and not a wedding ring to be seen reflecting the sparkle of afternoon light. At least two of the moms displayed tattooed cleavage above the squeeze of their strapless sundresses as they bent low to lift their dripping toddlers. Every mom is wearing shades. This, I noted, appears to be the year of the gold-rimmed aviator sunglasses. 

Jonah eyes, fortunately, were transfixed by the colorful rise and fall of merry-go-round horses on their gilded poles. He was listening intently to the carousel music and asked if the tunes were played live on a real organ—an instrument he hopes to learn to someday. Maybe he was considering future summer jobs—organ gigs at carousels and baseball parks.

"No, I don't think so. Just a recording. But I bet there used to be an organ in there at one time," I said. 

"Oh," he said, disappointed. He slowly dragged a limp french fry back and forth through a puddle of ketchup and then set it back down. "Ugh. I am roasting."

This is the kind of unseasonable heat that makes politicians climb onto their climate-change soapboxes and panicked consumers trade in their Hummers for pocket-sized electric cars. It is also the kind of weather that sends flabby humans of northern European descent out in herds to overwhelm the city streets and public parks with vast displays of blindingly pale flesh. Human dignity, it seems, cannot compete with the promise of a spring sunburn. Too-tight shorts and too-short tube tops parade unabashedly across the lush lawns while well-fed seagulls hop and flap eagerly after them, hoping a few bits of that muffin-top whiteness will drop in Wonder Bread crumbs to the ground. 

• • • • • •

The cool air of early morning is sweet when we walk to the car the next day, but as we pull onto the interstate to return to the hospital for Jonah's spinal tap, the sun is already poised to dominate the day—not so much as a hint of a cloud to interrupt the faintly blue expanse above us. Watching the drivers in the east-bound lane flipping down their visors and shielding their eyes with their hands against the rising glare, I am glad to be driving west.

Jonah tilts his seat back and snoozes on the way. I enjoy his company, but when he sleeps, I savor the silence—or rather, the steady hum and whoosh of the highway—instead. The rare luxury of uninterrupted thought makes me feel all glowingly poetic inside. I have a habit of trying to compose witty similes or apt metaphors while I'm driving in a quiet car. I imagine catchy first lines for short stories that I will never attempt to write. Often, I use the time to pray. This morning, however, I am thinking of styles of sunglasses, and how they seem to forge the way for styles of regular glasses, and how they serve better than carbon-14 for calculating the dates of old photos. (Ah, yes, 1982. The year of the saucer-sized frames with the graduated pink-tinted lenses.) This is deep stuff. 

The brilliance of my thoughts is interrupted by the sudden dimness of the hospital parking garage. Jonah sits up and looks around. He sighs, and his shoulders slump when he remembers where he is. 

• • • • • •

At last, the nurse steps into the waiting room and says Jonah's name. He sighs audibly again. He does have his favorite hospital activities that he looks forward to—especially when the music therapist is there. But on spinal tap days, he dreads the hospital because he knows how he will feel afterward. "You ready, buddy?" the nurse asks in that too-chipper, slightly condescending sing-song tone that he hates. He shakes his head firmly but stands up anyway, shoving his book into his backpack with unnecessary force. "O.K! Let's go!" she says, flashing coffee-stained teeth between freshly glossed lips. She takes brisk steps, but Jonah shuffles, and she has to turn and wait for him to catch up. The IV pole squeaks and rattles along the linoleum tiles, and I hold the IV line up to keep it from getting tangled in the wheels or caught underfoot.

In the procedure room, several nurses are waiting, and one of them attaches Jonah to several monitors—heart rate, blood pressure, oxygen levels. Then the anesthesiologist arrives to ask the usual list of questions. He's young and blond and wearing jeans and a massive silver ring and a silver bracelet below his rolled-up shirt sleeves. Very hip. He cracks a few jokes, makes small talk about sports, and manages to get a smile or two out of Jonah while filling syringes with milky-white propofol. "Milk of amnesia" he calls it.

At last the doctor arrives, all five-foot-aught of her, with her mass of brown corkscrew curls. Probably the world's cutest oncologist. The oxygen starts, then the proposal, and then Jonah's eyelids flutter closed. He's out. The doctor preps his back with iodine, and moments later Jonah's spinal fluid begins to drip slowly into a clear vial. A nurse walks quickly by us to prepare for the next patient's procedure, and her elbow knocks a vial of propofol onto the floor. It shatters, leaving a spray of glass shards and white liquid on the floor. The nurse gasps with dismay. "Oh, no need to cry over spilled propofol," I say dryly, and the whole room of doctors and nurses erupts into laughter. 

We're all still smiling as the oncologist injects a syringe full of acid-green methotrexate into Jonah's spinal fluid. And with that, the procedure's done. All that's left is to wait for him to sleep off the anesthesia. For most kids, this takes a matter of minutes. For Jonah, it can take hours for him to come around, and more often than not, he wakes up sick. This time, they wheel him into an infusion room where they let him recover by himself in a more comfortable bed. I turn down the lights and sit with him in the darkness for a few minutes, just to make sure he's resting quietly. Someone down the hall is carrying on a one-sided conversation in hurried Spanish. 

When I open the door to the hallway, my eyes take a moment to adjust. I return to the playroom to chat with the music therapist who has taught Jonah to play a few simple chords on the ukulele during previous visits. The room is hot and summer-bright. As she asks how Jonah's doing, I see the same mother and son from the waiting walk past the doorway and down the hall. 

A little girl walks in and immediately sits down to play with a large plastic dollhouse. Her mother has buzzed her own salt-and-pepper hair close to the scalp in order to, I assume, show her solidarity with her balding child. I've seen a few other parents who have done the same. Above her head is a computer printout on the wall depicting the complete pantheon of Disney princesses with egg-bald heads. Snow White on chemo. Sweet, I guess. 

When Jonah finally wakes up, it's well past noon, and he is woozy and nauseated, but I manage to help him to sit up and drink a sip of orange soda—the only thing that sounds palatable to him—before we head out the clinic doors. He carries a pink emesis bucket with him, just in case. Minutes later, we are back on the highway, driving home through miles and miles of velvety-green hills under a brilliant blue, cloudless sky. I am wearing last year's sunglasses. Soon we will be home. And Jonah is already talking of playing baseball.

Because I Could Not Stop for Death

"Look, Mom! A aaambulince!" sings a voice in the back seat of our van. We are waiting at a traffic signal on our way to pick up my big kids after school, and our eyes are drawn to the flashing lights and the cluster of people standing nervously in the grass outside the building on the corner. One woman has her eyes closed and her arms tightly crossed. Even though the day is unseasonably hot, she rubs her hands up and down her upper arms, as though she is trying to keep warm. Someone puts a friendly arm around her shoulders.

The kids behind me are bouncing with excitement. There's nothing quite like the flashdance of emergency lights to raise a thrill in the heart of a small boy. We have toys, puzzles, board books, and cartoons depicting every kind of car, truck, or van with lights on top, and our boys associate these automobiles with fun and amusement. We entertain our kids with the machinery that attends tragedy, and so it is no surprise that these boys of mine find pleasure in the grim song of sirens.

Small necks crane and blue eyes widen as we accelerate through the intersection and alongside the church-turned-movie-house-turned-tattoo-parlor where the scene is unfolding. A stretcher is about to emerge from the double doorway.

I tell myself that I must drive slowly here because one must be responsible and cautious—on the alert—when emergency vehicles are present. But the truth is that I drive slowly because I, too, am fascinated, filled with my own wide-eyed curiosity. But unlike my boys, I understand what these flashing lights must mean, and my interest in them is more gruesome than childlike. If I were being honest, I would tell myself that I am driving slowly because I hope we will catch a glimpse of a broken limb or a little blood.

What we see, however, is something much more unsettling.

"What happened to that guy?" my six-year-old asks, pointing. A man's shirtless body is wheeled through the open door and down to the sidewalk. I absorb what details I can in the few seconds it takes for my minivan to pass the scene. The man is young. His skin is smooth and  pale. A swirl of tribal motifs are inked along his motionless arm as one EMT rhythmically presses the heels of his hands into the man's chest and another prepares the paddles of a defibrillator. A third pulls upward to bring the stretcher through the back doors of the waiting ambulance. One of the bystanders has both hands pressed together over her mouth. And then the scene is behind us.

The colored lights spin their dizzy pirouettes in my rear-view mirror until we round a bend in the road and resume our afternoon routine. "I don't know what happened to him, buddy," I say, letting out the breath I didn't know I had been holding. My reply is delayed, my mind still processing what I've just witnessed. But the shudder that heaves through my neck and shoulders reveals my dark surmise: that what I just saw was the unexpected end of a story.

I do not say this to my sons. I keep my suspicion to myself, and instead I say, "We should pray for him, shouldn't we?" I put this in the form of a question, partly because I want to be assured that there is still a reason to say a prayer—that I did not, truly, see a fresh corpse on my afternoon carpool run. The soft "yeah" from my four-year-old helps calm my rattled nerves. Yeah. We should pray for him, for this tattooed stranger who might, or might not, already be dead. So we do. We pray for the people in the ambulance to take good care of him. We pray that the doctors at the hospital would be able to help him get well. I breathe a little more freely. But I still wonder if the man I saw will ever breathe—freely or otherwise—again.

And with that, my kids are on to the next topic—baseball, or the heat, or their brother's field trip. I don't remember. At school, I collect children, herd them across the parking lot and down the grassy hill back to the van, and buckle them in. Then we retrace our route back home, which means that we must pass the tattoo parlor.

We are, again, waiting for the signal to turn green. But this time the flashing lights are gone, and instead a group of people—mostly young—are gathered on the lawn. Some hold each other, some simply look stunned, and one sits near the curb with her knees touching her chin, her face in her hands, and her shoulders shaking with sobs while friends gather around to provide comforting words that she does not seem to hear.

I no longer suspect. I know. 

My second grader sees the dismal crowd and wonders aloud what has happened. I tell him about the ambulance. But for a moment I consider what else I should say, how much I should reveal. We are rolling forward again, and then I say it, "I think the man on the stretcher died."

"Really?" he asks, swiveling his head around for a second to look again at the mourners. And then he asks the same question that is in my own mind, "How did he die?" Heart attack? I wonder. He looked too young for that. Asthma attack? Plausible. Overdose? Not a very charitable thought, but there it is. All I can say is that I have no idea, but I can't help speculating.

For the next few days I scan the obituaries and death notices in the newspaper, expecting to put a face and a name with that inked and lifeless right arm, but there is nothing. And so again I begin to think that I might be wrong. Maybe he is still alive. Maybe that public display of grief was simply a manifestation of concern and stress—even emotional relief—in the aftermath of a medical scare. Maybe that nameless man is, at this moment, sitting up in a hospital bed eating Jell-o and mashed potatoes off a plastic tray.

On Friday morning, I pick up the newspaper and flip absently through the first few pages, this time not looking for an obituary, or for anything else in particular, when I find it: a photo of a young man. His name was Timothy, and he did not survive. No cause of death is mentioned, and so I will probably never know what took his life. He was very young—born in 1985—and his baseball cap is turned backwards, the corners of his mouth curving up slightly, giving him an expression of cheerful defiance. But he could not defy death.

A memorial service will be held at the tattoo parlor. It seems an odd location, unfit for so solemn an occasion. I wonder why his loved ones would choose his place of death as the place for remembering his life. It seems stranger still that a place that provides people with permanent ink could be an appropriate place to reflect on the impermanence of this life.

But then I am struck by the irony—and perhaps it is a bitter irony—that this particular tattoo parlor had once been a church. It had once been a place where earth had met with heaven, where sinners had sung their alleluias. It had once been a place where the dying had gathered and embraced the gift of everlasting life.

The Glorious Status Quo

I do not have cancer.

Normally, that wouldn't even be worth mentioning, but in this month of Thanksgiving, it's one bit of news that I'm very grateful for. Every so often something comes up that makes me realize how blessed I am to be enjoying just another uneventful day of "the same old thing."

Lately, "the same old thing" involves feeling about 13 months pregnant and consequently more than a bit sorry for my achy, tired, fat, slow self. And I'm not even having twins. In fact, as far as pregnancies go, mine are uncommonly easy—no morning sickness, no preexisting conditions, no miscarriages, no C-sections, no Strep B, no gestational diabetes. Nothing. "You are," a doctor once told me, "an obstetricians dream."

Nevertheless, when people ask me how I'm doing these days, I sometimes forget all that good news and want to respond with bitter sarcasm. You really want to know how I feel? Then try these ten easy steps to allow you to share in the third-trimester experience:

1. Place a 25-pound watermelon in a backpack or duffel bag, and strap it to your belly as tightly as you can so that it digs uncomfortably into your waist.
2. Adjust the straps so that the weight rests primarily on your lower back and hips. Just make sure that the melon sticks out at least a full 10 inches in front.
3. Put on ankle weights and four pairs of socks before cramming your feet into your now too-tight shoes.
4. Attempt to do routine household tasks such as getting out of bed, picking small items off the carpet, and hauling an overflowing laundry basket up and down the stairs several times a day.
5. Shortly before bedtime, consume a family-size jar of salsa, and wash it down with two or three quarts of soda. This will allow you to fully appreciate the heartburn and squashed bladder that pregnant women come to expect as they strive for a little shuteye.
6. Chew enough antacid tablets to let you sleep for an hour or so.
7. After no more than an hour of fitful slumber, attempt to roll over onto your other side.
8. Give up the attempt.
9. After another hour, have somebody elbow you repeatedly in the ribs to simulate the midnight acrobatics of your baby. You will then be wide awake enough to realize that you have to go to the bathroom. Again.
10. Repeat daily for three months.

Of course, if all goes well, when this new baby boy is finally placed in my arms, I'll again discover that it really was all worth it. I'll understand afresh what a privilege it was to carry another healthy child—something that countless heartbroken women in history have hopelessly longed to do. But right now, if I'm being honest, I'm usually looking forward less to meeting my son than to simply not being pregnant anymore.

But if I struggle with selfish resentment and impatience on account of a blessing like pregnancy, how would I cope with a true evil like cancer?

"Good timing" is, I suppose, a phrase that does not apply to a deadly disease. Serious illness is never welcome. But with four young kids and a husband dependent on my good health—not to mention a fifth baby who's roughly two weeks away from making his grand entrance—I can't help but think that this would be a truly terrible time of life to be diagnosed with cancer—far worse than, say, 30 or 40 years from now when our kids are grown and our nest is empty. So, as you can imagine, finding a mysterious lump in a place where it did not belong was not a pleasant discovery.

My first thought was, "Oh great." No fear. No anger. Just annoyance. I figured that it was, in all likelihood, simply another obnoxious pregnancy-induced growth. After all, everything else about me has been growing like mad. I feel like I am that scene in The Magician's Nephew during the creation of Narnia, when the whole of that new world is so full of life and growth that a broken bar of iron takes root and matures into a fully formed lamppost. Everything growing. Everything expanding. If I accidentally swallowed a watermelon seed right now, my grandfather's terrifying tale would become a reality; a vine would spring up and start producing juicy watermelons right inside my already crowded belly. So of course one more growth was entirely understandable, even if it was in an unusual place, right?

I figured my doctor would agree. However, at my next appointment, she didn't seem nearly as certain as I was that this was no cause for concern. When she told me to schedule an ultrasound exam, I felt my blood pressure rise just a little. And yet, I remained fairly confident that the ultrasound would confirm beyond doubt that this was totally normal. I prayed about it, but I didn't worry much.

Then, after the ultrasound, the radiologist came in and explained that, given my good health, my relatively young age, and the fact that I'm pregnant, this was most likely nothing serious, but he could not be entirely sure. This particular lump wasn't something he could diagnose merely by looking. The only way to know if it was cancerous was to perform a biopsy.

I don't know how it strikes others, but to me, "biopsy" is a rather scary word. It now brought the idea of cancer into the realm of real possibility. And, because I had been expecting an "all clear" from the ultrasound exam, it struck me as both scary and disappointing. I wanted this to be over. However, with my due date looming ever closer, I scheduled the dreaded biopsy appointment for the earliest available day.

I was nervous about the procedure, but as it turned out, an ultrasound-guided needle biopsy wasn't such a horrible experience—not something I'd like to do on a regular basis, but not a whole lot worse than having a few of cavities filled. 

I still didn't really think I had cancer, but waiting to find out was more of a test of my own trust in God's plans than I would have expected. I happen to be reading through the book of Job this month, and as I read chapter 13, I had to pause at verse 15: "Though he slay me, I will hope in him; yet I will argue my ways to his face."  Would I, if I were faced with this deadly disease, still be able with Job to hope in God? Could I argue my ways to his face?

Mercifully, the pathology report came back in just a couple of days. Those two days, however, gave me cause to meditate more than ever before on how everything I have, including my health, has been a gift, and that my life is not and never has been merely my own. You can imagine with what gratitude I heard the lovely word "benign" read to me at my next appointment. After facing the prospect—however remote—of a serious trial like cancer, the expectation of maintaining the status quo comes as the best kind of news. It comes like gospel.

So now I face two more weeks (give or take) of third trimester pregnancy. I am still achy. I am still tired. I am still fat and slow and prone to heartburn. I still get kicked in the ribs in the middle of the night. I am even coming down with a cold. But I also still get to enjoy another glorious day of the "same old thing."

Have Mercy on the Morons: A Plea on Behalf of the Misinformed

How do you know what you know?

That may seem like a pretty basic question, but it's a question that few of us are ever pushed to ask, let alone answer. It is a question, however, that has begun to bother me more than a little in recent years.

Of course, there are certain basic and unprovable assumptions that I must hold by faith as a Christian. Or even as a human being. Not every statement is up for debate. Whether we believe that God, or reason, or science, or Bono, or our own gut feeling is our ultimate standard for truth, we all have a place where the buck stops. All of our reasoning becomes circular when we get down to our most foundational beliefs.

I believe in the God of the Bible, and that necessitates that I reject any statements—however compelling—that directly contradict that belief. If someone asserts that theft is actually a good idea when you can get away with it, I can reject that statement without losing a single night's sleep, because it flatly defies the eighth commandment. Easy. But beyond the clear teachings of the Bible is a myriad of assertions that are anything but easy to assess. They require a degree of knowledge and wisdom that most of us will never attain. These are the kinds of questions that make me wonder how we really know what we "know."


A Matter of Trust
It's not that I lie awake at night worrying about this, and I have no plans for taking up the study of epistemology in my spare time. But honestly, every time one of my well intentioned Facebook friends posts another link to some piece of revisionist history, or alternative medicine, or political conspiracy, or any other article claiming to expose "hidden agendas" and "things the corporations don't want you to know," I feel like tearing my hair out.

It's not that I believe all these articles must be wrong. They may be absolutely right. Or mainly right. Or a little bit right about a few things. But therein lies my frustration; with the seemingly infinite number of "untold stories" out there, it's frequently impossible to know which stories to believe.

"Every charge may be established by the evidence of two or three witnesses" (Matthew 18:16). But what about all the times when the witnesses—even the "expert" witnesses—present conflicting evidence? When both the prosecution and the defense can call upon the testimony of two or three persuasive witnesses, how do I decide who makes a more convincing case? Daily life lacks the formality of a courtroom, and there are times when my decision cannot wait. I, of course, pray for wisdom, but often I must render my verdict while knowing full well that I have only part of the story and a few tidbits of sketchy evidence.

If, for example, somebody tells me that my government has lied to me about a particular event in the Middle East, I have to choose whom to believe if I am going to cast a "responsible vote." If there's been a cover-up, it is, well, covered up. There are many things I simply can't know. Do I trust the embittered soldier who was there? The apparently competent general who was also there? The commander in chief who saw the top-secret intelligence reports? The civilians who were affected on the ground? The talk radio host who interpreted the information? The NPR reporter who was embedded with the unit? The news anchor on Al Jazeera? The political blogger who scours the Web for possible leaks and insider stories? How do you know what you know?

I bring this up not because I want to start a discussion on foreign policy. I most certainly don't. And I don't want to sound like a relativist who thinks that all views are equally valid; I believe there's a vast gulf between truth and falsehood. I bring this up because I have found myself increasingly at a loss in sorting through the wildly differing "facts" littering my way as I try to navigate through life—especially through life as a parent.


The Curse of the Over-Informed Parent
In case you hadn't noticed, nearly everything we do for our kids requires careful thought. We need wisdom to sort through the barrage of opinions and studies and information and advice. Studies can be wrong, statistics can be twisted, and people on both sides of an issue can be less than objective in their approach. But the problem is, nobody I know has the time or resources to exhaustively research every possible option presented to us as parents. And because these decisions involve our kids—our future—emotions surrounding these choices tend to run rather high.

A typical mom might be disinterested in politics, apathetic about eschatology, bored by artistic trends. But bring up the topic of, say, childhood vaccines, and boom!  Watch the fireworks begin.

It's so very easy to assume that other parents who have made decisions different from our own have simply failed to understand the issues, or are too lazy to do their research, or have motives that aren't altogether pure. Maybe they've been brainwashed by propaganda. Maybe they haven't seen the shocking episode of 20/20 that we saw. Maybe they haven't talked to the right people. Maybe they're just stupid.

Or maybe, just maybe, they know something that we don't.

We can all agree on certain primary issues—that we should feed, clothe, educate and care for the health of our children. But the secondary details involving how we do those things can vary widely among wise and respectable people. We may all be diligently researching our options and still come to opposing conclusions. And that should hardly come as a surprise. We have studies and statistics bombarding us on every side, but rarely do they form any kind of consensus or any sense of certainty. As tidy as the word "data" may sound, the reality is anything but.


Expert Worship
We may have a pantheon of experts just a URL away, but the Cult of the Expert is a demanding and dizzying religion. First, we all slavishly follow the ex cathedra pronouncements of anybody in a white lab coat and a "Doctor of" diploma framed on the wall. But then some fringe heretic has the gall to stand up and point out that butter actually seems to be better for us than margarine after all and that the AMA and the USDA and the AAP have made some disastrous mistakes. We read the 95 Nutritional Theses nailed to the laboratory door, and our allegiances begin to shift.

Disillusioned by white lab coats, we turn with Reformation zeal to the unshaven nonconformist in Birkenstocks and a broomstick skirt who would expose for us the lies told by the priests of the old order. Down with the establishment! Let's pass out tracts! Let's evangelize the nations with the latest findings, baptizing them in the holistic name of the Protein, the Fat, and the Carbohydrates! Do I hear an "Amen?"

But wait a minute. Now the expert in the broomstick skirt is the establishment, and certain preventable diseases are seeing a global resurgence, to boot. The Holy Writ of the Expert must again be revised. But who will be our prophets and our priests now that nine out of ten nutritionists no longer agree? Which expert's Kool-aid are we going to drink next?

We could spend the rest of our lives chasing after the next "shocking revelation" offered up by the expert-du-jour, only to have each "important new study" undermined by the next.

The fact is, we can't run some kind of in-depth investigation into everything we hear. Not even close. And even if we could, we would still have to make faith-based decisions about what evidence to believe and how to interpret it. "Proof" is only as solid as the assumptions that underlie it. Even if I saw something with my own two eyes, I can still only know it happened if my own two eyes are trustworthy. (And that may be a very big "if.")

So the easiest solution is to turn to the Expert (blessed be he). He will tell us just what to do. No wisdom necessary. And when his advice fails us, we can blame, instead of ourselves, the evil pseudo-expert—the informational heretic—who led us astray.

But the real solution is, I believe, to remember where our true authority comes from and to realize that no earthly expert has a monopoly on knowledge. The data, however good and helpful, must be taken with a grain or two of (unrefined, natural Baltic Sea) salt.  The world is a messy place made up of messy people with messy motives, and while true knowledge about the world is attainable, exhaustive knowledge is not.

The older our kids get, the more I am amazed by the number of decisions we are required to make on their behalf. And the more decisions we have to make, the more I realize how much I just don't know. Socrates was on to something. I may not go so far as to say that I know nothing, but what I don't know definitely outweighs what I do. By a lot. Tons, actually.

This is why I have sometimes found myself wishing that an angel from heaven (a different kind of expert) would simply appear and tell me exactly whom to believe about things I'm told to do (or not to do) for the good of my children. But this is not going to happen, so we must proceed as wisely as we can with what information we can find in the time that we can set aside to find it. And in doing so, we must all—experts included—recognize that we have a whole lot left to learn. Additionally, we who are Christians must not lose sight of where the beginning of knowledge lies—with the fear of the Lord. That's our starting point. Whatever other knowledge we pursue must be built on that foundation.


A Toast to Ignorance
Even before they are born, I'm given conflicting information on all kinds of topics. Here's one bit of advice that's been printed everywhere from public bathrooms to health manuals: "Alcohol and pregnancy do not mix." The "experts" have a litany of scary statistics implying that an unintentional sip of grape juice gone bad could leave your unborn baby mentally impaired. So pregnant women nervously chew their nails wondering if they've ruined their child's life by drinking an entire cocktail before knowing they were expecting. But (as always seems to be the case) that's only one side of the story.

There are also scientific studies and statistics (mostly British) that have "proven" just the opposite—that children of women who drank "moderately" during pregnancy actually had brighter, better adapted children than those of women who had completely abstained. And some of these studies allege that it's fear of litigation that has (understandably) led most American obstetricians to advocate the total-abstinence policy, fearing that women will interpret permission to have a drink as permission to go on a month-long vodka binge.

So what to do? Better safe than sorry? Or better lighten up than stress out? Whom to believe? British doctors or American doctors? OBs or midwives? Your mom or that lady from the church potluck? I've tried to read a fair bit about this one, and the more I've read, the more I feel like reciting "eeny-meeny-miney-mo" is probably the best means of deciding the issue.

Sheesh. Please pass the shiraz.


Love and Let Live
I have more to learn than is humanly possible if I am going to make what might be called an "informed decision" about almost anything you can name. And so, I am guessing, do most of us. That is why I am writing this—not as a rant but as a plea for mercy. Share what you've learned for the good of your neighbor, and wisdom can be the result. Beat your neighbor over the head with the cold, hard facts, and somebody is going to get hurt. And it just might be the "facts" themselves that suffer.

In this messy world, charity is the necessary antidote to the idolatrous worship of expertise. Let us hear with gratitude—let us even seek out—what the knowledgeable have to say, but let us not bow down and kiss their feet.

If you see me nibbling on a Chicken McNugget; if you see me, with my pregnant belly, sipping on a mojito; if you see me taking my children for a vaccination; if you see me voting for the wrong candidate (shame on you for peeking); if you see me buying goods from the wrong store; if you see me doing anything else you would never, never do, I beg you to withhold your scorn and instead show a little mercy. I promise to do the same for you.